神经内镜下单鼻孔经蝶窦入路垂体腺瘤切除术中的垂体功能保护  

The surgical treatment of pituitary adenoma by neuroendoscopic unilateral endonasal transsphenoid and the protection of pituitary function

作　　者：白云驰[1] 阚志生[1] 崔永鹏[1] 刘宝军[1] 王欢[1] 

机构地区：[1]河北省开滦(集团)有限责任公司医院神经外科,唐山063000

出　　处：《中国综合临床》2009年第5期530-532,共3页Clinical Medicine of China

摘　　要：目的总结神经内镜下单鼻孔经蝶窦入路垂体腺瘤切除术中垂体功能保护的经验及体会。方法48例垂体腺瘤患者，单鼻孔经蝶窦入路，在神经内窥镜下行垂体腺瘤切除术，术中注意保护垂体柄及正常垂体组织。结果40例（83．3％，40／48）肿瘤全切除，6例（12．5％，6／48）次全切除，2例（4．2％，2／48）部分切除；术后随访10～36个月。38例激素水平异常患者中24例恢复正常，14例明显改善，38例均无垂体功能低下；术后多饮、多尿7例，均于3周内缓解。结论神经内镜下单鼻孔经蝶窦入路垂体腺瘤切除术，能够在彻底地切除肿瘤的同时注意保护垂体柄及正常垂体组织，可提高患者的生存质量。Objective To summarize the experience of unilateral endonasal transsphenoidal pituitary adenoma resection under neuroendoscopy. Methods 48 patients with pituitary adenoma were treated by unilateral endonasal transsphenoid under neuroendoscopy. During the dissection of the adenoma, attention should be paid to protect pituitary stalk and gland. Results The postoperative MRI detection revealed that the tumor was totally removed in 40 （83.3 % ） cases, subtotally in 6 （ 12.5 % ）, and partially in 2 （4.2%）. All patients were followed up for 10 -36 months. Among the 38 patients with increased hormone level,24 recovered to normal hormone level postoperatively; 14 were improved evidently ;pituitary insufficiency was not found in 38 cases ;7 patients have temporary diabetes insipidus but the symptom was released in three weeks. Conclusion The surgical treatment of pituitary adenoma by neuroendoscopic unilateral endonasal transsphenoid has its advantage in achieving both complete resection of tumor and sound protection of pituitary stalk and gland. Neuroendoscopic operation offers greater help in improving the patients＇ quality of survival.

关 键 词：垂体腺瘤 神经内窥镜 单鼻孔 蝶窦 

分 类 号：R736.4[医药卫生—肿瘤]